By Taylor Roberts, Pharm.D. candidate 2019, Ferris State University College of Pharmacy, Grand Rapids
What makes starting P4 rotations so nerve-racking? Is it the feeling you don’t remember anything from the first three years of pharmacy school? Or is it the fear of not knowing what to expect? Now that I am over two months into my P4 rotations, I conclude that it is a combination of both. All pharmacy students have their own perception of what they think rotations will entail. Some think it will be the best, most relaxed year of pharmacy school, while others think of it as preparing them for a residency. In my case, I didn’t know what to think. I had this vision in my mind that I was supposed to know everything I had ever learned, and I had to answer questions from physicians, preceptors and other peers right on the spot. I also thought it would be like working, that I would come home after my day and be able to enjoy my evening and not have anything to work on. I soon came to find out that my vision of P4 year was far from the truth and was a lot more work than I anticipated.
As I sat waiting to meet my preceptor in the lobby of the hospital on my first day of P4 rotations, I began to reminisce about the past three years of pharmacy school and thought about how it seemed like just yesterday I was starting my P1 year. I thought about a conversation I had a couple years prior with a friend. We had just finished our last final exam of P1 year, and I had never felt prouder of myself than I did in that moment. I turned to her saying, “I cannot believe we are done with our first year of pharmacy school!” To which she responded, “Yeah, but this just means people expect us to know more now.” This statement never felt truer than it did that Monday morning as I sat in the lobby waiting. I was afraid that I did not know enough from the past three years.
However, in no time at all, I settled in to my first rotation, and my fears of P4 year began to subside. I realized that it was okay to not know every answer right away, that Lexicomp® and treatment guidelines were my best friends, and most importantly, I realized that I did remember more from the past three years than I originally thought. However, the moment that made me realize that I could make it through this last year, and that I could be a pharmacist, was after I made my first recommendation. I was looking over a STEMI patient’s discharge medications. I noticed he was on all the core medications a typical STEMI patient should be on, except for an ACE inhibitor. After extensively searching the patient’s chart, as I wanted to make sure I did not miss any information stating why he was not on one, I brought it up to a pharmacist. We contacted the physician, and as a result, he added lisinopril to the patient’s list of discharge medications. At that moment, I knew I was going to make it through my P4 year.
My advice to pharmacy students nervous about starting rotations is to trust yourself. You know more than you think you know. Your P4 year is a learning experience. You will make mistakes, you won’t know everything and you will get questions wrong, but that is what rotations are for. Ask plenty of questions, review old notes, work hard and remember that your preceptors are your friends, not enemies.